       Document 0470
 DOCN  M9460470
 TI    Severe Pneumocystis carinii pneumonia produces a hyperdynamic profile
       similar to bacterial pneumonia with sepsis.
 DT    9404
 AU    Parker MM; Ognibene FP; Rogers P; Shelhamer JH; Masur H; Parrillo JE;
       Critical Care Medicine Department, Warren G. Magnuson Clinical; Center,
       National Institutes of Health, Bethesda, MD 20892.
 SO    Crit Care Med. 1994 Jan;22(1):50-4. Unique Identifier : AIDSLINE
       MED/94170652
 AB    OBJECTIVES: To investigate the effects of Pneumocystis carinii on the
       cardiovascular system. To compare the hemodynamic data from patients
       with P. carinii pneumonia with those data from patients with bacterial
       pneumonia with sepsis. DESIGN: Retrospective, descriptive study of
       prospectively gathered hemodynamic and clinical data. SETTING: Tertiary
       referral hospital, medical intensive care unit. PATIENTS: Forty-one
       consecutive patients with severe P. carinii pneumonia and 31 patients
       with bacterial pneumonia who had invasive hemodynamic monitoring for
       management of hypotension and/or hypoxemia. MEASUREMENTS AND MAIN
       RESULTS: On initial presentation, both groups had a hyperdynamic
       hemodynamic profile that included tachycardia, an increased cardiac
       index, and a low systemic vascular resistance index. The mean heart rate
       of the P. carinii pneumonia patients (113 +/- 3 beats/min) was
       significantly lower than that of the patients with bacterial pneumonia
       (126 +/- 4 beats/min). The cardiac index, systemic vascular resistance
       index, pulmonary vascular resistance index, and pulmonary artery
       pressures did not differ significantly between the two groups. The
       patients with bacterial pneumonia had a significantly lower mean left
       ventricular stroke volume index and stroke work index than the patients
       with P. carinii pneumonia. CONCLUSION: P. carinii can produce a
       hyperdynamic hemodynamic profile similar to that seen in patients with
       bacterial pneumonia with sepsis.
 DE    Acquired Immunodeficiency Syndrome/*PHYSIOPATHOLOGY  Adolescence  Adult
       Aged  AIDS-Related Opportunistic Infections/COMPLICATIONS/
       *PHYSIOPATHOLOGY  Bacterial Infections/*PHYSIOPATHOLOGY  Child
       Comparative Study  Hemodynamics  Human  Hypotension/COMPLICATIONS
       Intensive Care Units  Middle Age
       Pneumonia/*MICROBIOLOGY/*PHYSIOPATHOLOGY  Pneumonia, Pneumocystis
       carinii/COMPLICATIONS/*PHYSIOPATHOLOGY  Support, U.S. Gov't, P.H.S.
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

